Case study and physical exam are crucial to a proper diagnosis
Case History: This is one of the most important steps of assessing the patient.
A thorough case history will assist in determining the diagnosis of the patient.
The important information is:
- Onset of symptoms: spontaneous, head or visual motion provoked
- Temporal course: Is dizziness intermittent or continuous? Does it last seconds, minutes, hours, days or weeks?
- Type of dizziness: objects in room spinning, feeling of spinning in the head, imbalance, light headedness, disorientation, falls, unsteadiness
- Does the patient have signs of a central disorder (e.g. double vision, dysarthria, disturbances of sensation)?
- Other symptoms: nausea, vomiting, headaches, motion sickness, intolerance of light, oscillopsia, heart palpitations, feeling of panic, drop attacks
- Hearing: aural fullness, tinnitus (low or high frequency), progressive loss of hearing, fluctuating hearing loss, sensitive to noise, intolerance of sound
- Past medical history: head trauma, back surgery, ototoxic drugs (e.g. gentamicin), diabetes, perilymphatic fistula
Note: It is necessary to rule out central causes of dizziness (e.g. stroke, traumatic brain injury, cardiovascular disease,
neurological disorders (Multiple Sclerosis), anxiety, and side effects from medications or street drugs.)
Vestibular Neuritis, Meniere’s Disease, Vestibular Migraine, BPPV – which is it?